Provider Demographics
NPI:1295014165
Name:VICTORIA RYAN, LPC, PC
Entity Type:Organization
Organization Name:VICTORIA RYAN, LPC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:O
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,PC
Authorized Official - Phone:405-706-5032
Mailing Address - Street 1:3309 HEATHER GLEN TER
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-7633
Mailing Address - Country:US
Mailing Address - Phone:405-706-5032
Mailing Address - Fax:405-701-7127
Practice Address - Street 1:123 E TONHAWA ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-7209
Practice Address - Country:US
Practice Address - Phone:405-706-5032
Practice Address - Fax:405-701-7127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4210251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health